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目的观察鞘内不同剂量舒芬太尼复合罗哌卡因在腰硬联合阻滞分娩镇痛的效果,拟筛选出国人分娩镇痛最佳剂量。方法选择初产妇48例,随机分六组,单纯药物组(S3和R3组)和复合药物组(S2R2、S2R3、S3R2和S3R3组),双盲对照观察。各组均采用蛛网膜下腔给药后硬膜外腔留管产妇自控镇痛(CSE+PCA),且各组的硬膜外维持用药相同。观察记录镇痛起效时间、不同时间的VAS评分、镇痛维持时间、运动阻滞、各组产程、出血量、新生儿1min和5minApgar评分、镇痛满意度、剖宫产率、副作用等指标。结果镇痛起效时间复合药物组小于单纯药物组(P<0.05);复合药物组在各时间点的镇痛效果和镇痛满意度均优于单纯药物组,且镇痛维持时间明显长于单纯药物组(P<0.05)。结论2～3ug舒芬太尼复合2～3mg罗哌卡因鞘内给药可提供安全、有效的分娩镇痛效果,尤以3ug舒芬太尼复合2—3mg罗哌卡因效果更佳。
Objective To observe the effects of different doses of sufentanil combined with ropivacaine in analgesia induced by combined spinal and epidural blockade and to screen out the best dosage for analgesia in labor in China. Methods 48 primiparae were randomly divided into six groups: simple drug group (S3 and R3 group) and compound drug group (S2R2, S2R3, S3R2 and S3R3 group), and double-blind control. Epidural analgesia (CSE + PCA) was used in all groups after subarachnoid administration, and the epidural maintenance medication was the same in all groups. The time of onset of analgesia, VAS score, duration of analgesia, motor block, labor, blood loss, neonatal 1 min and 5 min Apgar score, pain satisfaction, cesarean section rate and side effects were observed and recorded . Results The analgesic and analgesic effects were better than those of the simple drug group (P <0.05). The analgesic effect and analgesic satisfaction of the composite drug group were better than that of the pure drug group at each time point, and the analgesic maintenance time was significantly longer than that of pure drug group Drug group (P <0.05). Conclusion 2 ~ 3ug sufentanil combined with 2 ~ 3mg ropivacaine intrathecal administration can provide safe and effective labor analgesic effect, especially 3ug sufentanil with 2-3mg ropivacaine better effect.